BEGINNING May 1, people on Guam in need of mental health services can contact the American Medical Center in Upper Tumon.

Recognizing a need for more mental health providers in the community, the clinic has formed an alliance with seven individuals who are certified to provide services but are not currently in private practice. Addressing the most common obstacles to running a practice, the clinic will provide space and administrative support – to include scheduling appointments, dealing with insurance-company paperwork, and billing.

“Mental health access for Guam citizens who have not yet committed a crime has been increasingly restricted,” said Dr. Vince Akimoto, principal partner of American Medical Clinic. Court-ordered referrals to the Department of Mental Health and Substance Abuse and to private mental health professionals, and the demands of such institutions as the Guam Department of Education, the Department of Veterans Affairs and the judicial system have increased the demand for mental health professionals on-island. “Many mental health providers have been forced to give up their private practice in order to service the growing institutional needs on-island.”

The providers echoed Akimoto’s assessment during an introductory get-together at the clinic on Wednesday. “I haven’t been in private practice for the past couple of years mainly because of the business aspect,” said Trish Lizama, currently an assistant professor in the social work program at the University of Guam. Valerie Reyes, program director at Sanctuary Inc., said she has had trouble finding a suitable office in which to practice. “I need a place to do my work so I can do what I love, and that’s drug and alcohol counseling,” she said.

Paperwork

Lisalinda Natividad, chairwoman of UOG’s social work program, said she had been in private practice for a number of years, before joining the UOG faculty. “We just don’t have time for the paperwork,” she said. “We would love to see clients, but on the business side we really need to find a way to be more efficient.” She said that in the past week, she had been contacted by five individuals about mental health care. “The community need for this is really intense and is not being met at all.”

Natividad added that practicing in affiliation with American Medical Center would permit them to offer a more integrated form of care, as most individuals with mental health issues initially contact a primary care physician with physical symptoms.

“If someone comes in and says, ‘I’m going to hurt someone’ or ‘I’m suicidal,’ we send them to Mental Health and that’s not been a really good situation; they generally send them back out,” Akimoto said. “Mental Health is not built to deal with people who are voluntarily saying, ‘I need help.’ The court will do it for you, but you have to commit a crime first.”

Among the tasks facing AMC as it undertakes the administrative responsibility for the mental health providers will be ensuring that that the providers’ credentials and licenses are up to date and meet the requirements of insurers, Medicaid and other payers. Under federal guidelines, many employers including the federal government and contractors “have specific requirements that have been, up to this point, unfilled,” Akimoto said.

“From the insurance side, we always like to see that we can get more providers in a network to provide the necessary services to our members,” said Francis Santos, president of StayWell Insurance. “So the service that Dr. Akimoto, through the American Medical Clinic, is providing is a crucial aspect of the operation, which is the billing aspect.”

Brihinia Hosei Habin, health care manager for NetCare, said while a number of details remain to be worked out, including the providers’ fees, AMC’s involvement will be helpful because of the staff’s experience with billing, and the consolidation of the practices. “Our community really needs mental health providers,” she said. “This integrated services approach is phenomenal.”